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The Future Is Not What It Used to Be
Published in Tom Lawry, Hacking Healthcare, 2022
New technologies are being developed that blur the lines between computers and biology. The emerging field of neurotechnology involves brain-machine interfaces, neuroprosthetics, neurostimulation, and implantable devices that not only augment nervous system activity but expand its capabilities.
Advances in Neuroprosthetics
Published in Chang S. Nam, Anton Nijholt, Fabien Lotte, Brain–Computer Interfaces Handbook, 2018
We often have a short memory when considering the history of technology. This is not difficult to understand, given that the current state of technology has little in common with its earlier brethren. This reality is notably salient in neuroscience and prosthetics—especially so in their remarkable melding, neuroprosthetics: devices linked to the peripheral or central nervous system and enhance the cognitive, motor, or sensory abilities of an organism (Medical Dictionary 2009). Moreover, it is equally enlightening to glimpse the future of neuroprosthetics through the lens of its accelerating research, development, and convergence with non-neurological areas of inquiry, as is the case with several fields of science and technology currently seen as independent (National Research Council 2014; Roco 2003; Roco and Bainbridge 2003, 2013).
Restoration: Nanotechnology in Tissue Replacement and Prosthetics
Published in Harry F. Tibbals, Medical Nanotechnology and Nanomedicine, 2017
Motor neuroprosthetic devices take signals from the brain or motor nerve pathway and convert that information into control of an acuator device to execute the user’s intentions. Motor neuroprosthetics work in one of two ways, either by (1) translating motor nerve impulses to electrical stimulation that excites or inhibits neuromuscular paths to paretic or paralyzed organs and limbs (functional electrical stimulation), or (2) picking up electricity generated by the brain or nerves and interpreting it to control prostheses or assis-tive devices (device control). In both cases, nerve signals can be interfaced to the neuroprosthesis by recording electrical impulses externally through the surface of the skin (myoelectric control) or through implanted electrodes.
Amputee, clinician, and regulator perspectives on current and prospective upper extremity prosthetic technologies
Published in Assistive Technology, 2023
Julie Rekant, Lee E. Fisher, Michael L. Boninger, Robert A. Gaunt, Jennifer L. Collinger
It is important to mention that the fully implanted sensorimotor neuroprosthesis presented (called the “MyoTouch” for brevity in the surveys) is a hypothetical device that was proposed as an example of an advanced prosthesis that combines implanted myoelectric control and somatosensory feedback. While our findings may be broadly applicable to implantable neuroprosthetics, we caution that the results are likely impacted by the specifics of this conceptual device. Interestingly, acceptance of this technology was not impacted by level of amputation (below elbow vs. at or above elbow) even though the proposed sensorimotor device was presented as targeting those with amputations below the elbow. This may indicate good translatability of the results to neuroprosthetic technology in general.
Stimulation of abdominal and upper thoracic muscles with surface electrodes for respiration and cough: Acute studies in adult canines
Published in The Journal of Spinal Cord Medicine, 2018
James S. Walter, Joseph Posluszny, Raymond Dieter, Robert S. Dieter, Scott Sayers, Kiratipath Iamsakul, Christine Staunton, Donald Thomas, Mark Rabbat, Sanjay Singh
There is a continuing need to develop improved methods to assist with ventilation and cough following SCI, particularly in individuals with tetraplegia.27 Current results with surface electrodes and the 12-Channel Neuroprosthetic Platform extends our prior findings toward this goal.11,25–31 Further study is needed, because some of the current studies were limited to only two or three animals and other limitations cited above. Clinical testing of some of the current methods, however, is warranted because surface electrode stimulation is widely used in patients with SCI.19–23 Such testing depend on the level of spinal cord injury because the stimulation has to be applied in non-sensate areas. For SCI at low spinal cord levels, surface stimulation is limited to lower thoracic and abdominal muscles. For individuals with cervical level SCI, surface stimulation could be applied to both extradiaphragmatic muscles for expiration. For individuals receiving phrenic nerve stimulation for diaphragmatic inspiration, stimulation of the extradiaphragmatic muscles could be coordinated with the diaphragm. Monitoring during upper thorax stimulation should include EKG recording to assess the occurrence of heart arrhythmia, which, if observed, would mandate stopping stimulation.
Disorders of Consciousness, Agency, and Health Care Decision Making: Lessons From a Developmental Model
Published in AJOB Neuroscience, 2018
Megan S. Wright, Claudia Kraft, Michael R. Ulrich, Joseph J. Fins
When possible, the surrogate and physician must also be flexible about the timing of conversations with patients in the MCS or who have emerged with significant disabilities. A patient's functioning may be much better one day than the next (Giacino et al. 2002), and care should be taken to hold these discussions at times when the patient is best able to communicate. As mentioned previously, drugs, devices, and rehabilitation may also help facilitate this, as there is evidence that some medications can temporarily improve the functioning of these patients (Fins 2015; Giacino et al. 2014; Whyte and Myers 2009). It is hoped that some patients who use neuroprosthetics may even become fully capacitated to make their own health care decisions. Such factors need to be considered to help patients realize their full potential in the decision-making process.